PMT16-00399 City of Menifee Permit No.: PMT16-00399
29714 HAUN RD.
-I-►CCEL/1�. MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 02/17/2016
PERMIT
Site Address: 27848 WILD SAGE CT, MENIFEE,CA Parcel Number: 336-370-034
92585 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of REPLACE 4-TON A/C, COIL AND FAU
Work:
Owner Contractor
LERA HUMPHREY W C HEATING&AIR CONDITIONING INC
27848 WILD SAGE COURT 41085 GOLDEN GATE CIR
MENIFEE, CA 92585 MURRIETA, CA92562
Applicant Phone:9516000700
ERIC BARNETT License Number:779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description O_yt Amount 151
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 14.10
$324.10
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for sift months,shall expire,and fees paid shall be
forfeited.
AA_Blog_Pemit_Template.rpl Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from Iicensure under the Contractors'State License Law forth
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence ii
Professions Code andiw license is in full force and effe t. u which I must have resided for at least one year prior to completion c
License Class License l`�o. 7 6�7 improvements covered by this permit, I cannot legally sell a structure that I haw
Expires 6 76 /'d Signature ` — built as an owner-building if it has not been constructed in its entirety by license,
contractors. I understand that a copy of the applicable law,Section 7044 of thh
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application t
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one the following declarations: hftv:ffiAmmieginfo.ca.gov/calaw.htmi.
1 have and will maintain a certificate of consentt of self-Insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner orAuthodzed Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the propert
fl 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read thf:
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to compl,
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to butldinr
9 ` construction.I authorize representatives of this city or county to enter the above
CarrierPMr-r*#1XC_ Is/AWA1I.44r identified property for the inspection purposes.
Policy# SAW 46fa I" Expires /�/ 7 Date
Properly Owner orAuthodzed Agent
(This section need not be completed if the permit is for City Business License# v ��
one-hundred dollars($100)or less)
❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. ❑YES r�v0
Applicant; G. Date; Z//7I�� Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideline
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES QNO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounds school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous pdedal reporting.
OWNER BUILDER DECLARATIONS DYES NO �.
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 6 Date /7 (6
License Law for the reason(s)Indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct,alter, improve,demolish, EPA RENOVATION,REPAIR AND PAINTING IRRP)
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with
she is exempt from Iicensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
Violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPNs Renovation Program visit:
www.epa.govAead or contact the National Lead Information Center at
❑ 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
❑ 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contrectorls)oursuant to the Contractors State License Law). If your Droiect does not comaly with EPA RRP rule please fill out the RRP
BUILDING E SAFETY PERMIT/PLANAPPLICATION
kMenifee
DATE 02/16/2016 PERMIT/PLAN CHECK NUMBER
TYPE: [:]COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA [-]SIGN
SUBTYPE: [-]ADDITION []ALTERATION [-]DEMOLITION []ELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK REPLACE 4 TON AC,COIL AND FAU
PROJECTADDRESS 27848 WILD SAGE CT alas
ASSESSOR'S PARCEL NUMBER f25Lp - 310 LOT TRACT
PROPERTY OWNER'S NAME LERA HUMPHREY
ADDRESS 27848 WILD SAGE CT
PHONE (951)723-8875 EMAIL
APPLICANT NAME ERIC BARNETT
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123
PHONE (619)384-6622 EMAIL ERIC@WEGREENINC.COM
CONTRACTOR'S NAME RUSSELL COCHRAN OWNER BUILDER? ❑YES ✓❑NO
BUSINESS NAME WC PLUMBING, HEATING&AIR
ADDRESS 41085 GOLDEN GATE CIR MURRIETA,CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $ 12,000.00 SO FT 1741 L SO FT
APPLICANT'S SIGNATURE DATE 02/16/2016
I„ -
DEPARTMENT DISTRIBUTION CITYb IE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT /jam
AMOUNT �O to 0CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 1 0CASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-677 7
www.cityofinenifee.us Inspection Request Line 951-246-6213
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